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|Zocor Zocor

Zocor

Generic name: Simvastatin
Brand names: Zocor

Why is Zocor prescribed?

Zocor is a cholesterol-lowering drug. Your doctor may prescribe Zocor in addition to a cholesterol-lowering diet if your blood cholesterol level is too high, and if you have been unable to lower it by diet alone. For people at high risk of heart disease, current guidelines call for considering drug therapy when LDL levels reach 130. For people at lower risk, the cut-off is 160. For those at little or no risk, it"s 190.

In people with high cholesterol and heart disease, Zocor reduces the risk of heart attack, stroke, and "mini-stroke" (transient ischemic attack) and can stave off the need for bypass surgery or angioplasty to clear clogged arteries. Zocor can also reduce these risks in people with diabetes, peripheral vascular disease, and a history of stroke.

Most important fact about Zocor

Zocor is usually prescribed only if diet, exercise, and weight-loss fail to bring your cholesterol level under control. It"s important to remember that Zocor is a supplement to--not a substitute for--those other measures. To get the full benefit of the medication, you need to stick to the diet and exercise program prescribed by your doctor. All these efforts to keep your cholesterol levels normal are important because together they may lower your risk of heart disease.

How should you take Zocor?

Take Zocor exactly as prescribed.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine whether it is safe for you to continue taking Zocor.

• More common side effects may include:
  Abdominal pain, headache

Why should Zocor not be prescribed?

Do not take Zocor if you have ever had an allergic reaction to it or are sensitive to it.

Do not take Zocor if you have active liver disease.

Do not take Zocor if you are pregnant or plan to become pregnant.

Special warnings about Zocor

Because Zocor may damage the liver, your doctor may order a blood test to check your liver enzyme levels before you start taking the drug. Blood tests will probably be done before your treatment is started and at periodic intervals for a year after your final dosage increase. If your liver enzyme levels rise too high, your doctor may tell you to stop taking Zocor.

Since Zocor may cause damage to muscle tissue, be sure to tell your doctor of any unexplained muscle tenderness, weakness, or pain right away, especially if you also have a fever or feel sick. Your doctor may want to do a blood test to check for signs of muscle damage.

If you are scheduled for major surgery, your doctor will have you stop taking Zocor a few days before the operation.

Possible food and drug interactions when taking Zocor

Zocor tends to enhance the effects of the blood-thinning drug Coumadin and the heart medication Lanoxin. Combining it with the following drugs increases the chance of muscle damage:

Amiodarone (Cordarone)
Clarithromycin (Biaxin)
Clofibrate (Atromid-S)
Cyclosporine (Sandimmune, Neoral)
Erythromycin (PCE and others)
Fenofibrate (Tricor)
Gemfibrozil (Lopid)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Nefazodone (Serzone)
Nicotinic acid or niacin (Niaspan)
Protease inhibitors (used in the treatment of HIV), including Agenerase, Crixivan, Fortovase, Invirase, Norvir, and Viracept
Verapamil (Calan)

If you are taking Zocor with any of these drugs (or with large quantities of grapefruit juice) alert your doctor immediately at the first sign of muscle pain or weakness. If you need to take erythromycin, Biaxin, Nizoral, or Sporanox, the doctor may temporarily take you off Zocor.

Special information if you are pregnant or breastfeeding

You must not become pregnant while taking Zocor. This drug lowers cholesterol, and cholesterol is needed for a baby to develop properly. If you do become pregnant while taking Zocor, notify your doctor right away. Based on studies of other cholesterol-lowering drugs, it is assumed that Zocor could appear in breast milk and could cause severe adverse effects in a nursing baby. Do not take Zocor while breastfeeding your baby.

Recommended dosage

You will have to follow a standard cholesterol-lowering diet before starting treatment with Zocor and continue this diet while using Zocor.

All doses should be adjusted to your individual needs.

ADULTS

The usual starting dose is 20 to 40 milligrams once a day in the evening. If your cholesterol level or heart attack risk is especially high, the doctor may start with a dose of 40 milligrams. The dosage can be adjusted every 4 weeks. Some people with severe, hereditary high cholesterol may be prescribed as much as 80 milligrams a day, taken in doses of 20, 20, and 40 milligrams, along with other treatments.

Those who have severe kidney disease should use Zocor with caution. The recommended starting dose is 5 milligrams per day.

When combined with cyclosporine, niacin, Atromid-S, Lopid, or Tricor, the dosage of Zocor should not exceed 10 milligrams a day. When combined with Calan or Cordarone, the dosage of Zocor should not exceed 20 milligrams a day.

CHILDREN 10 TO 17 YEARS OLD

The recommended starting dose is 10 milligrams once a day in the evening. The dosage may be increased every 4 weeks, as determined by the doctor, up to a maximum of 40 milligrams a day. Girls must have been menstruating for at least 1 year before starting therapy with Zocor.

The safety and effectiveness of Zocor in children under 10 years old or in doses greater than 40 milligrams a day have not been studied.

Overdosage

Although no specific information about Zocor overdose is available, any medication taken in excess can have serious consequences. If you suspect an overdose of Zocor, seek medical attention immediately.